Congressional Democrats ask feds to look into Medicaid unwinding

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The Florida Democratic congressional delegation sent a letter to the Centers for Medicare and Medicaid Services (CMS) asking it to take a closer look to make sure Florida follows the rules when it comes to unwinding its Medicaid program from the public health emergency.

If not, the letter asks CMS to take action to prevent any unnecessary and improper loss of coverage.

According to the Kaiser Family Foundation, which tracks Medicaid unwinding data, Florida has disenrolled more than 730,000 individuals from Medicaid since April when it began its redetermination process. Another 1.5 million people have been reenrolled.

KFF data shows that more than half (51%) of those disenrolled for procedural reasons which occurs when there is no definitive determination of ineligibility.

The main concern with procedural disenrollments is that many people losing Medicaid for these paperwork reasons may still be eligible and do not have another source of health coverage.

“We are particularly concerned that through October 2023, Florida has disenrolled 201,078 children from the Medicaid program, while the net enrollment in KidCare — Florida’s Children’s Health Insurance Program (CHIP) — has only been 25,281,” the letter reads.

The letter asks CMS to take action to prevent any unnecessary and improper loss of coverage.

The Department of Children and Families told lawmakers earlier this month that every child disenrolled from the Medicaid program is automatically referred to Florida KidCare.

But Florida’s congressional Democrats aren’t assuaged by the Gov. Ron DeSantis administration’s attestations. The delegation notes that Florida is the only state that didn’t take advantage of federal flexibilities made available during the unwinding period.

“We strongly encourage CMS to investigate whether the state is complying with all federal rules and regulations regarding Medicaid redetermination,” the letter reads. “If necessary, we urge you to use every tool at your disposal, including potentially exercising statutory authorities to issue corrective action plans or pause procedural terminations, to ensure the state remedies serious flaws in its redetermination process.”

The letter is the latest complaint against the DeSantis administration over the Medicaid unwinding. A lawsuit has been filed in federal court by advocates who allege the state termination notices to Medicaid beneficiaries are confusing, provide inadequate explanations for the state’s decision, and lack specific information about how to appeal the state’s decision.

A civil rights complaint has been filed by a coalition of groups that are alleging the state’s Medicaid redetermination process discriminates against minorities, particularly Latino, Black and immigrant individuals. A study found that English-language callers had an average wait time of 36 minutes, but Spanish-language callers had an average wait time of 142 minutes in Florida.